Damon A. Black, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

056409 Issued in GA

Practice address

901 N Broad St NE
Suite 220
Rome, GA 30161-5207

Phone

(706) 291-2077

Fax

(706) 235-4177

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

University of Texas Southwestern Medical School at Dallas, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Universal Radiology Consultants PCGroup PAC ID 2769485655, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Spalding Medical Center Hospital, Griffin, GA, CCN 110031
• Coffee Regional Medical Center, Inc Hospital, Douglas, GA, CCN 110089

Merit-based Incentive Payment System (MIPS)

Final score

79.74 of 100Reported as group

Quality

63.81

Promoting interoperability

100

Improvement activities

40

Cost

57.71

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dblack145491@cityofhope.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Universal Radiology Consultants PC

  • Diagnostic Radiology Physician
  • Warner Robins, GA
  • NPI 1689606188
  Medicare reassignment Care Compare group
• City of Hope Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Newnan, GA
  • NPI 1447520333

  Diagnostic Radiology

  Medicare reassignment NPD
• Harbin Clinic, LLC

  • Ambulatory Surgical Clinic/Center
  • Cartersville, GA
  • NPI 1467016055
  NPD (past)
• Rome Imaging Associates

  • Nuclear Radiology Physician
  • Rome, GA
  • NPI 1013923820
  NPD (past)
• Rome Radiology Group, PA

  • Diagnostic Radiology Physician
  • Rome, GA
  • NPI 1952330615

  Body Imaging

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Coffee Regional Medical Center, Inc

  • General Acute Care Hospital
  • Douglas, GA
  • NPI 1760419527
  Care Compare affiliation
• Wellstar Spalding Regional Hospital, Inc

  • General Acute Care Hospital
  • Griffin, GA
  • NPI 1972535318
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1225071616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620369",
            "telephone_number": "706-291-2077",
            "fax_number": "706-235-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N BROAD ST NE",
            "address_2": "SUITE 220",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301615207",
            "telephone_number": "706-291-2077",
            "fax_number": "706-235-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "DAMON",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "GA",
            "license": "056409",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "GA",
            "license": "056409",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "GA",
            "license": "056409",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "056409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "649332244A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GEORGIA",
            "identifier": "923350",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Leigh Bishop
• Nitza Chea Bishop
• Bison Ridge Recovery Lodge, LLC
• Joseph D. Biuso, M.D.
• BKD Rome Operator, LLC
• Kimberly Black, PT
• Lisa Blake, MD
• Amiria Blakely
• Jessica Morgan Boatner, PHARM.D.
• Marius Florin Bodiu, DPT

• Diagnostic Radiology Physician in Rome, GA
• Providers in Rome, GA by specialty
• Diagnostic Radiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.